household survey nyanja short screen - plos

SURVEY ID

1

Instrument ID: The MAHMAZ Project Baseline Impact Evaluation – Household Survey NYANJA Target Audience: Women who have delivered a child in the last 12 months, who are ≥ 15 years of age, and who live within the study facility catchment areas

SHORT SCREEN SS1 Kodi ndi angati azikazi azaka khumi ndi

zisanu (15) kufika pa zaka makhumi anayi zisanu ndi zinayi (49) amakhala pakhomo lino, kuphatikizapo ndi amene anamwalira kapena kuchokapo mu miyezi khumi ndi ziwiri zapitazi? Write down the number of women.

If none, thank person and move to next household.

SS2 Kodi kuli akazi anabereka mwana mu myezi khumi ndi ziwili (12) yapita (chaka chimodzi), kosaganizira zolondola pa umoyo wa amayi kapena mwana?

YES (1) NO (0) DON’T KNOW (96)

If (0) or (96), thank person and move to next household

SS3 Ngati mkazi wabanja lino palibe, kodi mungayanke mafunso ya mimba ndi ubeleki wake?


INTERVIEWER: IF YOU HAVE ANSWERED YES TO SS1 AND YES TO SS2, THEN PROCEED WITH THE INFORMED CONSENTING PROCESS. PLACE THE UNIQUE ID STICKER ON THE INSTRUMENT AND ON THE HOUSEHOLD CONSENT FORM A. ***Confirm consent was granted***

Draw a check mark if consent was granted.

IF CONSENT WAS GRANTED, PLACE A SECOND UNIQUE ID STICKER ON THE PAPER VERSION OF THE INSTRUMENT.

SURVEY ID

2

MODULE A. LOCATION INSTRUCTIONS: Complete before administering the rest of the survey

NO. FIELD CODE RESPONSE A1 Province EASTERN (1)

SOUTHERN (2) LUAPULA (3)

A2 District CHOMA (1) KALOMO (2) PEMBA (3) LUNDAZI (4) NYIMBA (5) MANSA (6) CHEMBE (7)

A3 Health Facility Catchment Area CHOMA DISTRICT CHOMA GENERAL (801001) MANGUNZA (801019) MACHA MISSION (801002) MASUKU MISSION (801021) MBABALA (801022) MOCHIPAPA (801023) SIMAKUTU (801043)

KALOMO DISTRICT CHIFUSA HC (804023) CHILALA HC (804024) DIMBWE HC (804019) HABULILE HC (804032) KALOMO DISTRICT HOSPITAL (804002) KANCHELE HC (804014) MAWAYA HC (804034) MOONDE HP (804042) MUKWELA HC (804020) SIACHITEMA HC (804013)

PEMBA DISTRICT JEMBO (801413) MUZOKA (801419)

NYIMBA DISTRICT CHIPEMBE RHC (307010) HOFMEYR ZONAL HC (307011) KACHOLOLA RHC (307012) MKOPEKA RHC (307016) NYIMBA DISTRICT HOSPITAL (307001)

MANSA DISTRICT FIMPULU (403017) KABUNDA (403018) LUBENDE (403041) MANO (403026) MANSA GENERAL HOSPITAL (403001) MIBENGE (403029) MUSAILA (403030) MUTITI (403031) MUWANGUNI (403032)

CHEMBE DISTRICT

SURVEY ID

3

KUNDAMFUMU (403023) LUKOLA (403037)

LUNDAZI DISTRICT CHIKOMENI (405026) KAMSARO (305034) KAPICHILA (305023) LUKWISIZI (305040) LUNDAZI HOSPITAL (305032) LUSUNTHA (305021) MWASE LUNDAZI ZONAL (305011) NKHANGA (305046) NYANGWE (305020) PHIKAMALAZA (305031)

ZUMWANDA (305024) A4 Village Name

Write in the name of the village.

GPS COORDINATES, TAKE 1 A5 Latitude

A6 Longitude

GPS COORDINATES, TAKE 2 A7 Latitude (decimal format)

A8 Longitude (decimal format)

A9 Date of Interview (DD/MM/YYYY) A10 Start time of interview

(24:00 format)

A11 ***Confirm consent was granted*** Draw a check mark if consent was granted.

SURVEY ID

4

MODULE B. HOUSEHOLD ENUMERATION INSTRUCTIONS: Confirm that the person who you are speaking with is the head of the household or the head woman of the household. INTERVIEWER: "Tsopano ndiza kufunsani mafunso okhudza inu ndi anthu amene mukhala nao panyumba ino. Kulingana ndi funso ili, titaunzire kuti banja inanthu amene akhala pamodzi, kuphika pamodzi komanso kudyela limonzi ndiponso amayang’anila pa munthu umadzi kukhala mutu wa banjalo.”

NO. QUESTION POTENTIAL RESPONSES SKIP B1 Kufikira pachikumukiro cha tsiku

lanu laku badwa lotsiriza, munali ndi zaka zingati zakubadwa? Unit of response in years.

B2 Kodi unapitako ku sukulu? YES (1) NO (0) DON’T KNOW (96)

If (0) or (96), skip to B4

B3 Kodi ni grade bwanji yapamwamba yamene munasiliza? If <1 year completed, write down 00. If >12 years completed, write down 13.

DON’T KNOW (96)

B4 Kodi chipembedzo chanu nichiti? CATHOLIC (1) PROTESTANT (2) MUSLIM (3) OTHER (SPECIFY) (4)

B5 Ndimwe atundu bwanji?

B6 Kodi udindo wazachikwati wanu uli bwanji?

MARRIED/COHABITING (1) DIVORCED (2) SEPARATED (3) WIDOWED (4) NEVER-MARRIED (5)

If (2), (3), (4), or (5), skip to B8

B7 If respondent is the male head of household: Ni chiwerengelo bwanji cha akazi amene muli nawo? If respondent is NOT male head of household: Ni chiwerengelo bwanji cha akazi chamene amuna a banja lino ali nawo?

B8 Kodi ni ambiri bwanji anyamata ndi atsikana osakwana zaka zisanu (5) amene ankala pakhomo lanu kawirikawiri?

BOYS GIRLS

SURVEY ID

5

Include children who are in boarding school at the moment. If none, write down 00.

B9 Kodi ni ambiri bwanji anyamata ndi atsikana azaka zapakati pa zisanu (5) ndi khumi ndi zinayi (14) amene ankala pakhomo lanu kawirikawiri? Include children who are in boarding school at the moment. If none, write down 00.

BOYS GIRLS

B10 Kuikilapo ndi inu, kodi ni ambiri bwanji amuna ndi akazi azaka zapakati pa khumi ndi zisanu (15) ndi makhumi anayi zisanu ndi zinayi (49) amene akhala pakhomo lanu kawirikawiri?

MEN WOMEN

Kuikilapo ndi inu, kodi ni ambiri bwanji amuna ndi akazi azaka zapakati pa khumi azisanu (15) ndi makhumi anayi zisanu ndi zinayi (49) amene ankala pakhomo lanu kawirikawiri, kuphatikizapo amene ana mwalila mu myezi yokwana khumi ndi ziwili (12) zapita?

MEN WOMEN

B11 Kuikilapo ndi inu, kodi ni ambiri bwanji amuna ndi akazi azaka zapakati pa makumi asanu (50) ndi pa nkhumi asanu ndi limodzi ndi zinayi (64) amene akhala pakhomo lanu kawirikawiri?

MEN WOMEN

B12 Kuikilapo ndi inu, kodi ni ambiri bwanji amuna ndi akazi azaka makhumi asanu ndi limodzi ndi zinai (65) kapena kwambiri amene ankala pakhomo lanu?

MEN WOMEN

INSTRUCTIONS: Count and record the total number (B8 to B12) of household members.

B13 Tsimikizani ndi woyankha: Kotero kuli okwana (chiwerengero) anthu amu banja lanu?

YES (1) NO (0)

SURVEY ID

6

INSTRUCTIONS: Ask the respondent to list the names of all women aged 15-49 in the household, including those who passed away in the last 12 months (1 year). Emphasize that you are also looking for information on individuals who have passed away in the last 12 months (1 year). Fill out column A with all names provided, and then continue to answer B-F for each person before selecting a respondent.

INTERVIEWER: "Tsopano ine ndikufuna inu kuti mundiuzeko mazina a akazi onse amene kawirikawiri amakhala pakhomo lino ammene ali ndizaka zapakati pa zaka khumi ndi zisanu (15) ndi zaka makhumi anayi zisanu ndi zinayi (49). Nipempa mundiuzenso mazina ya akazi omwe ana mwarira myezi zapita zokwana khumi ndi ziwili (12) (chaka chimodzi). " TABLE 1. ROSTER OF WOMEN AGED 15-49 YEARS

A.Nipempa muniuze madzina loyamba ndi zaka ya akazi onse a zaka zapakati pa khumi ndi zisanu (15) ndi azaka makhumi anayi zisanu ndi zinayi (49) amene nthawi zambiri amakhala pakhomo iyi kwa masiku anai a musondo umodzi, kuphatikizapo amene ana mwalila mu myezi yokwana khumi ndi ziwili (12) zapita. Ensure the number includes those who would have been living there if they didn’t pass away/move away in the past 12 months. The number of women in this list should be greater or equal to the number of women in B10.

B. Mu myezi zapita khumi ndi ziwili (12), kodi anakhalapo ndipakati po pyola masabata makhumi atatu ndi asnu (35)? YES (1) NO (0) DON’T KNOW (96) If (0) or (96), skip to next person.

C. kodi (dzina) ali moyo? YES (1) NO/DON’T KNOW (0) If (1), skip to E.

D. Kodi muli wokonzeka kapena wina wachekuyankha mafunso ya zamimba ya (*name)? YES (1) NO (0) If (0), skip to next person.

E. Is (name) potentially eligible to take the survey? If B=1 and (IF APPLICABLE) D=1, mark the box below.

AFTER ALL WOMEN HAVE BEEN LISTED, TO SELECT A RESPONDENT: 1. Roll the die 2. From the 1st checked box in Column E, count up to the rolled number, beginning again at the 1st checked box if needed until number is reached 3. Roll the die again 4. From the checked box you landed on after the 1st roll, count up to the 2nd rolled number, beginning again at the 1st checked box if needed until the 2nd number is reached 5. Select this woman 6. If woman selected is ALIVE, proceed to Question B24 7. If woman selected is DECEASED, proceed to Proxy Household Survey

B14 □

B15 □

B16 □

B17 □

B18 □

B19 □

B20 □

B21 □

SURVEY ID

7

B22 □

B23 □

SURVEY ID

8

NO. QUESTION POTENTIAL RESPONSES SKIP B23A Kodi (*name) ali ndi zaka zokubadwa

zingati? Input name

B24 Kodi (*name) alipo kuti angayanke mafunso? Input name


If (1), skip to consent then proceed to B27

B25 Kodi ife tingakonze nthawi ina ya kubwera pamene iye adzakhala alipo?


If (0) or (96), resample from potentially eligible women in TABLE 1

B26 Were you able to reschedule another time?

YES (1) NO (0)

If (0), resample from potentially eligible women in TABLE 1

If you are unable to reschedule a time to come back and survey the sampled woman, go back to TABLE 1 and resample another potentially eligible woman. If you are re-visiting the household a subsequent time and the woman is now available, proceed from Question B27.

INSTRUCTIONS: Make sure to obtain consent or assent (if the sampled woman is 15, 16 or 17 years old – refer to B23A), including a signature, from the sampled woman. If the woman is not able to sign, please have the woman provide a thumbprint. These questions will determine whether or not the sampled woman is eligible to proceed to the full household survey. If she is ineligible, then re-sample from Roster Table 1. If there are no more potentially eligible women to sample from, thank the woman and move on to the next household. If she is eligible, proceed to Module C. STOP: MAKE SURE CONSENT OR ASSENT WAS OBTAINED FROM (NAME). PLACE A THIRD UNIQUE ID STICKER ON THE CONSENT FORM B – FOR THE ELIGBLE WOMAN. INTERVIEWER: "Zikomo kwambili pa kutengako mbali pa kafukufuku wathu. Tsopano ine ndikuti ndikufunseni inu mafunso ya ubeleki wa mwana anabadwa posachedwapa.”

NO. QUESTION POTENTIAL RESPONSES SKIP B27 Kodi mwana wanu ali moyo?

Soften the question by asking: Is your baby around?


If (1), continue to Module C If (96), skip to B29

B28 Kodi mwana yanu anamwalira liti? BEFORE OR ON DAY OF DELIVERY (1) WITHIN ONE MONTH AFTER DELIVERY (2) OTHER (3)

If (2) or (3), continue to Module C

B29 Kodi munabeleka mwana kamusanga kosakwana masiku yamene munali kuyembekezeleka?


If (0), continue to Module C If (96), end and re-sample from Roster Table 1

SURVEY ID

9

B30 Kodi mwana anabadwa kutatsala ma sabata angati pa tsiku iomwe munali kuyenela kuchilirapo?

<= 3 WEEKS (1) >3 WEEKS (2) DON’T KNOW (96)

If (1), continue to Module C If (2), end and re-sample from Roster Table 1 If 96, end and re-sample from Roster Table 1

MODULE C. DEMOGRAPHICS INSTRUCTIONS: After eligible respondent has been randomly sampled from all eligible respondents, proceed with the instrument. Ensure that the woman selected to proceed with the survey has delivered a child within the last year. This section is to get basic demographics on the household and the respondent. INTERVIEWER: "Ine tsopano ndikuti ndikufunseni inu mafunso ena okhudza inuyo ndi banja lanu."

NO. QUESTION POTENTIAL RESPONSES SKIP C1 Kodi ndinu mutu wabanja? YES (1)

NO (0) If (1), skip to C9

C2 Ni cibale cotani cilipo pakati pa imwe na wamutu wabanja?

SPOUSE (1) CHILD (2) GRANDCHILD (3) NIECE (4) AUNTIE/OTHER RELATIVE (5) OTHER (SPECIFY) (6):

C3 Kodi munaphunzilako sukulu?


If (0) or (96), skip to C5

C4 Kodi maphunzilo yanu yanafika pati? If <1 year completed, write down 00. If >12 years completed, write down 13.

DON’T KNOW (96)

C5 Kodi ndimwe wa chipembedzo cabwanji?

CATHOLIC (1) PROTESTANT (2) MUSLIM (3) OTHER (SPECIFY) (4):

C6 Kodi ndinu amutundu bwanji?

C7 Kodi ukwati wanu ni wotani? MARRIED/COHABITING (1) DIVORCED (2) SEPARATED (3) WIDOWED (4) NEVER-MARRIED (5)

If (2), (3), (4) or (5), skip to C9

SURVEY ID

10

C8 Ndi chiwelengelo chotani cha azimai kuwonjeza cisumbali cymene amuna anu alinacho? If don’t know, write down 96.

C9 Muna khalapo na mimba kangati?

C10 Kodi munabalapo ana amoyo angati?

INTERVIEWER: “Tsopano tikambe za nyumbayanu.”

NO. QUESTION POTENTIAL RESPONSES SKIP C11 Kodi banja lanu kawirikawiri

imatunga kuti manzi yamene mukumwa?

PIPED WATER PIPED INTO DWELLING (1) PIPED TO YARD/PLOT (2) PUBLIC TAP/STANDPIPE (3) TUBE WELL OR BOREHOLE (4) DUG WELL PROTECTED WELL (5) UNPROTETED WELL (6) WATER FROM SPRING PROTECTED SPRING (7) UNPROTECTED SPRING (8) RAINWATER (9) TANKER TRUCK (10) CART WITH SMALL TANK (11) SURFACE WATER (12) (RIVER/DAM/LAKE/POND/STREAM/CANAL/ IRRIGATION CHANNEL) BOTTLED WATER (13) OTHER (PLEASE SPECIFY) (14):

If (13), skip to C14

C12 Madzi mutenga kuti? IN OWN DWELLING (1) IN OWN YARD/PLOT (2) ELSEWHERE (3)


C13 Mumatenga mpindi zingati kupita ndi kubwela poka tenga madzi?

MINUTES (1): DON’T KNOW (96)

C14 Kodi mumachita chilichonse kumadzi kuti yankale ambwino kumwa?


C15 Ndi cimbudzi cotani camene inu ndi banja lanu mugwiritsa nchito nthawi zambili?

FLUSH OR POUR FLUSH TOILET FLUSH TO PIPED SEWER SYSTEM (1) FLUSH TO SEPTIC TANK (2) FLUSH TO PIT LATRINE (3) FLUSH TO SOMEWHERE ELSE (4) FLUSH, DON’T KNOW WHERE (5) PIT LATRINE VENTILATED IMPROVED PIT LATRINE (6) PIT LATRINE WITH SLAB (7) PIT LATRINE WITHOUT SLAB/OPEN PIT (8) COMPOSTING TOILET (9) BUCKET TOILET (10) HANGING TOILET/HANGING LATRINE (11) NO FACILITY/BUSH/FIELD (12) OTHER (SPECIFY) (13):

SURVEY ID

11

C16 Kodi musebenzesa cimbudzi chimodzi ndi banja ena?

YES (1) NO (0)

C17 Kodi banja lanu liri ndi mbali

zotsatirazi (item must be functioning usually):


A MAGESI □ □ □

B MAGESI

YAPANGIDWA NDI ZUWA

□ □ □

C MAGESI YA MUCHINI □ □ □ D

NYALE YA MAFUTA YA PALAFINI □ □ □

E FILIJI □ □ □ F MICROWAVE □ □ □ G MBAULA YA MALASHA □ □ □ H MBAULA YA NKHUNI □ □ □ I CHITOFU CHA MAGESI □ □ □ J BEDI □ □ □ K MATILESI □ □ □ L MPANDO □ □ □ M THEBULO □ □ □ N KABATI □ □ □ O MIPANDO YA SOFA □ □ □ P KOLOKO □ □ □ Q FANI □ □ □ R MASHINI YOSOKELA □ □ □ S KOMBE YA UDZUZU □ □ □ T INTERNET □ □ □ U NKOLOKO YA PA MANJA □ □ □ V

BUKU LA BANKI /SAVINGS ACCOUNT □ □ □

W KHASU LOLIMILA NDI

NGOMBE □ □ □

X WILIBALA □ □ □ Y CHOGAILA NDI MANJA □ □ □ Z TALAKITA □ □ □ AA CHIGAYO □ □ □ BB FOSHOLO □ □ □ CC MACHETE □ □ □

SURVEY ID

12

DD PIKI / NKHWANGWA □ □ □ EE

MUCHINI WOPOMPA MADZI □ □ □

FF MALO OLIMAPO □ □ □ GG

MITENGO YOBELEKA ZIPATSO □ □ □

HH WAYALESI □ □ □ II WAYALESI YA KANEMA □ □ □ JJ

TELEFONI YAPA THUMBA □ □ □

KK TELEFONI YA MUNYUMBA □ □ □

LL COMPUTER □ □ □ MM

CASSETTE PLAYER □ □ □

NN VCR/DVD □ □ □ OO NJINGA □ □ □ PP MTHUTHUTHU/SKUTA □ □ □ QQ KOCHIKALA □ □ □

RR GALIMOTO

YONYAMULILAMO ANTHU/ KATUNDU

□ □ □

SS BWATO LOYENDA NDI

MPHAMVU ZA MUCHINI □ □ □

TT

BWATO LOYENDETSEWA NDI MPHAMVU ZA

ANTHU □ □ □

C18 Kodi pophika mumagwiritsa nchito

ciani? ELECTRICITY (1) SOLAR POWER (2) LIQUID PROPANE GAS (LPG) (3) NATURAL GAS (4) BIOGAS (5) KEROSENE (6) COAL, LIGNITE (7) CHARCOAL (8) WOOD (9) STRAW/SHRUBS/GRASS (10) AGRICULTURAL CROP (11) ANIMAL DUNG (12) NO FOOD COOKED IN HOUSEHOLD (13) OTHER (SPECIFY) (14):

If (13), skip to C20

C19 Kodi muma phikira kuti pa nyumba pano?

IN THE HOUSE (1) IN A SEPARATE BUILDING (2) OUTDOORS (3) OTHER (SPECIFY) (4):

C20 Kodi pansi panyumba yanuyi mpopangidwa ndi ciani?

NATURAL FLOOR EARTH/SAND (1) DUNG (2)

RUDIMENTARY FLOOR WOOD PLANKS (3)

SURVEY ID

13

OBSERVE THE FLOOR TO CONFIRM. (If more than one material, select the one that is “most” common)

PALM/BAMBOO/REEDS (4) FINISHED FLOOR

PARQUET/POLISHED WOOD (5) VINYL (PVC) OR ASPHALT STRIPS (6) CERAMIC/TERRAZZO TILES (7) CONCRETE CEMENT (8) CARPET (9)

OTHER (SPECIFY) (10): C21 Kodi mtenje wa nyumba yanuyi

ndiopangidwa ndi ciani? OBSERVE THE ROOF TO CONFIRM. (If more than one material, select the one that is “most” common)

NATURAL ROOFING NO ROOF (0)

THATCH/PALM LEAF (1) RUDIMENTARY ROOFING

RUSTIC MAT (2) PALM/BAMBOO (3) WOOD PLANKS (4) CARDBOARD (5)

FINISHED ROOFING METAL/IRON SHEETS (6) WOOD (7) CALAMINE/CEMENT FIBRE (ASBESTOS) (8) CERAMIC/HARVEY TILES (9) CEMENT (10) ROOFING SHINGLES (11) MUD TILES (12)

OTHER (SPECIFY) (13):

C22

Kodi nyumbayi inapangidwa ndi ciani mu zipupa za kunja? OBSERVE THE WALLS TO CONFIRM. (If more than one material, select the one that is “most” common)

NATURAL WALLS NO WALLS (0) CANE/PALM/TRUNKS (1) MUD (2) RUDIMENTARY WALLS BAMBOO/POLE WITH MUD (3) STONE WITH MUD (4) PLYWOOD (5) CARDBOARD (6) REUSED WOOD (7) FINISHED WALLS CEMENT (8) STONE WITH LIME/CEMENT (9) BRICK (10) CEMENT BLOCKS (11) WOOD PLANKS (12) OTHER (SPECIFY) (13):

C23 Kodi alimo wina aliyense mbanja mwanu amene ali ndi malo ocitilapo nchito ya za ulimi?



C24 Ndi ma yekala kapena malo ya akulu bwanji amene banja lanu lilanao?

LIMA (1) QUANTITY ACRES (2) HECTARES (3) SQUARE METERS (4) DON’T KNOW (96)

SURVEY ID

14

C25 Kodi ndizingati mwa ziwetozi banja lanu lirinazo? NUMBER NONE (00) DON’T KNOW

(96)

A NGOMBE ZA KUMUDZI

□ □

B NGOMBE ZA MKAKA

□ □

C NGOMBE

□ □

D HORSES KAPENA DONKEYS KAPENA MULES

□ □

E MBUZI

□ □

F MBELELE

□ □

G NKHUMBA

□ □

H NKHUKU/ KAPENA ZINA ZA MIYENDO IWIRI

□ □

I KALULU

□ □

J ZIWETO ZINA

□ □

NO. QUESTION POTENTIAL RESPONSES SKIP C26 Musonyeze zonse njira zamene

mupedzelamo ndalama pano pakhomo mu myezi yokwana khumi ndi ziwili (12) zapita. Select all that apply.

SALARIED EMPLOYMENT (1) SMALL BUSINESS, SHOP OR KIOSK (2) SMALL HOUSEHOLD INCOME GENERATING ACTIVITY (3) DOWRY (4) SALE OF CROPS/ANIMALS (5) SALE OF ASSETS (6) REMITTANCES (CASH DONATIONS FROM FRIENDS/FAMILY) (7) GOVERNMENT/NGO AID, GRANT OR OTHER FINANCIAL SUPPORT (8) CASUAL DAILY WORK (9) OTHER (SPECIFY) (10):

C27 Mutafuna kukongola ndalama kucokela ku banki kapena bungwe lina lililonse (kucoselako abwenzi ndi abale), kodi banja lanu linga kwanise kukongola ndalama?

NO (0) PROBABLY NOT (1) PROBABLY YES (2) DEFINITELY YES (3) DON’T KNOW (96)

C28 Kodi akazi ali napakati ndi ana azaka zochepekera zisanu (5) anagona mu kombe la udzuzu usiku watha?


SURVEY ID

15

C29 Mumakwanilisa kulipira zonse zofunika za ana kusukulu, ndalama zolipiliwa ndi zofunika zina?

YES (1) USUALLY (2) SOMETIMES (3) RARELY (4) OTHER (SPECIFY) (5): NO (0)

C30 Mumwezi wathawu, paliko bena amene anakhala tsiku lathunthu ndi usiku kosadya cakudya ciliconse?


C31 Kodi paliko ana aliwonse anagona njala usiku wathawu?


C32 Kodi nuumba yanu itha kupirira mphepo kapena mvula yamablogu popanda kuwononga?


C33 Ngati kwagwa mvula, mtenje wanyumbayi kumbali yomwe kugona ana siyathonya madzi?


MODULE D. LAST DELIVERY/MOTHERS’ SHELTER INTERVIEWER: "Tsopano ndizakufunsani mafunso okhuza ubeleki wanu wa catsopano apa. Talingalilani panthaui ya pafupi ndi kubeleka kumanso kubeleka, potsalira tilankhulane pa za chipanda odi ca azimai apakati. Mwakonzekera? "

NO. QUESTION POTENTIAL RESPONSES SKIP D1 Munabeleka liti mwana wa last

kupela? (DD MONTH YYYY) ___ ___ ___ ___ ___ ___ ___ ___ D D M M Y Y Y Y

D2 Kwatsopano apa, kodi munamvapo za apanda odi ca azimai apakati?


If (0) or (96), skip to D18

D3 Kodi munamvapo kwayani pa aya manyumba? Muyankhe zonse zopezekapo

CHIEF (1) HEADMEN (2) HEALTH CARE WORKER (3) SMAG (4) TRADITIONAL BIRTH ATTENDANT (5) FAMILY MEMBER (6) ANOTHER MOTHER (7) OTHER COMMUNITY MEMBER (8) RADIO (9) OTHER (SPECIFY) (10):

D4 Pakuganizira pa zaubeleki takhala tikuyankhulapo, kodi munakhalapo muzi-panda odi izi mukalibe kubeleka kapena mutabeleka kale?

YES (1) NO (0)

If (1), skip to D5

D4a If NO, why? NO MOTHERS SHELTER (1) Skip to D18

SURVEY ID

16

Select all that apply.

NO PERMISSION FROM HUSBAND OR FAMILY (2) NO MONEY (3) POOR QUALITY (4) NOT CLEAN (5) TOO CROWDED (6) NOT CULTURALLY APPROPRIATE (7) NOT SAFE (8) DELAYS DELIVERY (10) DIDN’T KNOW ABOUT MOTHERS SHELTER (11) OTHER (SPECIFY) (12):

INSTRUCTIONS: Ask the respondent for what reason(s) did she stay at a mothers’ shelter, and then prompt her with the reasons listed below.

D5

Masiku yangati mudakhala ku zipanda odi komanso pa zifukwa zotani?

NUMBER OF NIGHTS NONE (0) DON’T KNOW (96)

A ULENDO WA ANC WOYAMBA

□ □

B MAULENDO YA ANC ENA

□ □

C PAMENE TIKUYEMBEKEZERA

MIMBA YOBELEKA

□ □

D

PAMBUYO POCHOSEDWA MUCHIPATALA KAPENA PAMBUYO POBELEKA

□ □

E

SIKU LACHITATU (3) PAMBUYO PA ULENDO WA POST NATAL

□ □

F

SIKU LOKWANA KUYAMBA PA ZISANU NDI ZIWIRI (7) KUFIKA PA KHUMI NDI ZINAYI (14) PAMBUYO PA ULENDO WA POST NATAL

□ □

G

MILUNGU zisanu ndi chimodzi (6) PAMBUYO WA ULENDO WA POST NATAL

□ □

H ZINA (MUTCHULE)

□ □

NO. QUESTION POTENTIAL RESPONSES SKIP D6 Nipati pa cipanda odi pamene

inu munankala kwanthawi yaitali?

CHOMA DISTRICT CHOMA GENERAL (801001) MANGUNZA (801019) MACHA MISSION (801002) MASUKU MISSION (801021)

SURVEY ID

17

Confirm the longest number of nights the respondent stayed at a mothers’ shelter.

MBABALA (801022) MOCHIPAPA (801023) SIMAKUTU (801043)





CHEMBE DISTRICT KUNDAMFUMU (403023) LUKOLA (403037)


ZUMWANDA (305024) OTHER (SPECIFY NAME OF HEALTH FACILITY AND DISTRICT) (47):

INTERVIEWER: "Tsopano ine ndikuti ndikufunseni inu zo munapitamo pamene munali kucipanda odi. Patulani nthawi kuganizira nkalidwe yanu panthawi iyo. Mwakonzeka kuyamba? "

D7 Pamene munali kunkala kucipanda odi amayi ... YES (1) NO (0) DON’T KNOW (96)

SURVEY ID

18

A PADALI BEDI KAPENA MATIRESI YOGONAPO INU? □ □ □

B

KODI MUNAGABANA BEDI KAPENA MATIRESI NDI MUNTHU WINA PA NTHAWI ILIYONSE

□ □ □

C

KODI INU MUNAGONAPO MU MOSQUITO NET NTHAWI YA USIKU

□ □ □

D

ANA KUDZIWISANI PA ZA MUKHALIDWE KAPENA MALAMULO A MUCHIPANDA ODI PAMENE MULANGO FIKA PAMALO AWA?

□ □ □

E KODI MUNALI NDI DANGA LAKUGWIRIKA NCHITO MADZI AUKHONDO

□ □ □

F

KODI MUNALI NDI NYALI LA KUUNIKA PAMBUYO PA KU LOWA DZUWA

□ □ □

G

KODI KUNALI MALO OSAMBILA KAPENA YO WASHILA

□ □ □

H

KODI PANALI MALO ABWINO OYIKHA ZINTHU ZANU NDI CHAKUDYA

□ □ □

I

KODI MUNANKHALAPO NDI MAPUNZILO AZAUMOYO

□ □ □

NO. QUESTION POTENTIAL RESPONSES SKIP D8 Kodi panali malo opikila

panyumba yachipanda odi?



D9 Kodi malo yophikilayo yanali ndi mutenje kapena ai?


D10 Kodi inu munapezako luso latsopano pamene munali kuchipanda odi?



D11 luso lotani limene munatenga?

SURVEY ID

19

D12 Kodi anakufunsani kuti mulipile ndalama iliyonse kuti mukhalepo panyumbai?



D13 Nenani ni ndalama zingati zomwe munalipila zonse pamozi?

D14 Kodi anakufunsani kulipila kanthu kena kalikonse paku khalapa nyumbai?



D15 Munapelekanji? (Select all that apply)

LABOR (1) LIVESTOCK/POULTRY (2) FOOD OR OTHER AGRICULTURAL RESOURCES (3) OTHER IN-KIND RESOURCES (SPECIFY) (4): OTHER (SPECIFY) (5):

D16 OFUNSA MAFUNSO: “Lomba nizakufunsani mafunso pamavuto yoziwika yomwe azima amapeza pa

nthawi yokhalamumanyumba yoyembekezela azimai akalibe ucila. Pali zonse izi zati nichule, conde inu niuzeni ngati munapezako/upezamo bvuto, pakakhalidwe kanu munyumba ya azimai zoyembekezela ndiponso munene ngati inali vuto lalikulu kapena ai.”

MAJOR PROBLEM (2)

MINOR PROBLEM (1) NO PROBLEM (0) UNDECIDED (96)

A ZONSE MUNYUMBAI NI ZA MTENGO WAPATALI □ □ □ □

B KASUNGIDWE KA MALO NDI ZOLAKWIKA □ □ □ □

C UKHONDO □ □ □ □ D KUPEZEKA KWA ANYANCHITO □ □ □ □ E UBWENZI WA ANYANCHITO □ □ □ □ F UFULU WOFIKA KUMALO

OPHIKIRA □ □ □ □

G KUMAPEZEKA ANTHU AMBIRI □ □ □ □ H ZA CITETEZO □ □ □ □ I KUNVESA ULESI □ □ □ □ J MIYAMBO YOYENELA □ □ □ □

NO. FUNSO YANKHO YOYENERA PITANI D17 Mkalidwe waa’panda odi unali

okondwelesa bwanji?

KWAMBIRI ZOKWANILITSIDWA (1) KAPENA ZOCHEPA ZOKWANILITSIDWA (2) SAKUKHUTITSIDWA (3)

D17a Kodi muli ndiganizo yoza yembekezela kuchipanda odi pa ubeleki wa msogolo?


SURVEY ID

20

D17b Kodi mungalibikitse abale kapena abwenzi kusebenzetsa zipanda odi?


INTERVIEWER: "Zikomo pa kuyankha mafunso ya zipanda odi. Tsopano ine ndikufuna kukambirana nanu pa za ubeleka wanu wa posachedwapa kachiwiri. "

D18 Nindani anakuthandizani pakucila nthawi yathai? Select all that apply. If respondent says NO ONE ASSSISTED, probe to determine whether any adults were present at the delivery.

DOCTOR/CLINICAL OFFICER (1) NURSE/MIDWIFE (2) OTHER HEALTH FACILITY STAFF/PERSONNEL (3) TRADITIONAL BIRTH ATTENDANT (4) SMAG (5) RELATIVE/FRIEND/AUNTIE (6) NO ONE ASSISTED (7) OTHER (SPECIFY) (8):

D18a Munali kufuna kakacilira kuti?

YOUR HOME (1) OTHER HOME (2) HEALTH POST/FACILITY (3) HOSPITAL (4) OTHER (SPECIFY) (5):

D18b Munali kufuna kukachilira kuti pa ubeleki wa mtsogoro?


D19 Kodi muna belekela kuti mwana wanu wotsilizila?


If (1), (2) or (5), skip to D31

INSTRUCTIONS: If respondent answers OTHER (5) to Question D19, probe to ensure this is not a health post/facility or hospital.

FACILITY-BASED DELIVERY NO. QUESTION POTENTIAL RESPONSES SKIP D20 Nicipatala citi coyamba

camene munapitako kuti mubeleke nthawi yathai? (INSTRUCTIONS: if woman reports hospital, probe to ensure she did not first present at a health facility and was transferred to hospital.)

CHOMA DISTRICT CHOMA GENERAL (801001) MANGUNZA (801019) MACHA MISSION (801002) MASUKU MISSION (801021) MBABALA (801022) MOCHIPAPA (801023) SIMAKUTU (801043)

KALOMO DISTRICT CHIFUSA HC (804023) CHILALA HC (804024) DIMBWE HC (804019) HABULILE HC (804032) KALOMO DISTRICT HOSPITAL (804002) KANCHELE HC (804014)

SURVEY ID

21

MAWAYA HC (804034) MOONDE HP (804042) MUKWELA HC (804020) SIACHITEMA HC (804013)







D21 Kodi popita kucipatala munapita bwanji?

WALKING (1) BICYCLE (2) CARRIED IN WHEELBARROW (3) ANIMAL-DRAWN CART (4) TAXI (5) CAR (6) MOTORCYCLE (7) AMBULANCE (8) OTHER (SPECIFY) (9):

D22 Munatenga maola angati kukafika kucipatala?

Be sure to specify unit of response.

HOURS MINUTES

SURVEY ID

22

D23 Kodi munabelekela kucipatala komwe mumabelekela ana anu kwanthawi zonse?


If (1) or (96) skip to D27

D24 Kodi ndi dzina lotani la chipatala mudabereka mwana wanu?

CHOMA DISTRICT CHOMA GENERAL (801001) MANGUNZA (801019) MACHA MISSION (801002) MASUKU MISSION (801021) MBABALA (801022) MOCHIPAPA (801023) SIMAKUTU (801043)








SURVEY ID

23

D25 Kodi anakutumani kapena kukupelekani kucipatalaci anchito zacipatala?



D26 Panapita nthawi yayi tali bwanji pamene inu munapelekedwa kuchipatala?

LESS THAN 1 HOUR (1) 1 TO 2 HOURS (2) MORE THAN 2 HOURS (3)

D27 Kodi anapanga ganizo loka belekela kucipatalaci ndani?

YOURSELF (1) HUSBAND/PARTNER (2) MOTHER/MOTHER-IN-LAW (3) AUNTIE (4) OTHER FAMILY MEMBER (5) FRIEND (6) OTHER (SPECIFY) (7):

D28 Kodi munankhala kucipatala kwa maola osacepekela makhumi yabili ndi anai (24) pambuyo pobeleka musanatulutsidwe?


D29 INTERVIEWER: “Apa ndizacula zinthu zothandizila anthu zomwe acipatala amacitandi lingo lofuna

kudziwa ngati munalandilako zina mwa izi pomwe munapita kukabeleka nthawi yathai.” RECEIVED (1) DID NOT

RECEIVE (0) DON’T KNOW

(96)

A

Kodi mwana wanu wotsiriza anabadwa munjira ya opareshoni? Ici citanthauza

kutsegula kwa pamimba ndi kucotsamo mwana ndi kutsekanso?

□ □ □

B Kodi pomwe munabeleka anakuikanikoni magazi? □ □ □

C Munkhwala wama Antibiotics kapenanso intravenous (IV) drip-kuikiwa madzi mthupi □ □ □

D Uphunzitsiwa pa kuyamwisa mkaka mwana □ □ □ E Kukonzekera mankhwala ya cilezi kapena

uphungu □ □ □

F Uphungu osamala mwana ngati kangaroo (khungu kwa khungu) amasamalila mwana wake □ □ □

D30 INTERVIEWER: “Apa lomba nizafunsa paza mavuto yomwe azimai amapitamo kuja kucipatala pa nthawi

yobeleka. Ndiza chula vuto imodzi-imodzi, ndiye munene ngati inalipodi vuto yoteleyi ndiponso munene ukuluwake wavutoli kwa inu kulingana ndi zamene munapitamo.”

VUTO LALIKULU (2)

VUTO LALING’ONO (1) KULIBE VUTO (0) SADZIWA (96)

A

MTENGO NDI UBWINO WA MOMWE

ANAKUSAMALILANI ACIPATALA POBELEKA

□ □ □ □

B

ULEMU OMWE ANAKUPASANI ANCHITO

ZACIPATALA □ □ □ □

SURVEY ID

24

C KUBELEKELA MUCIPINDA COBISIKA □ □ □ □

D

UKHONDO KAPENA ODONGO WA

PACIPATALA □ □ □ □

After completing the facility-based delivery section, continue to MODULE E.

HOME DELIVERIES No. Question Potential responses Skip D31 Nindani analamulila kuti inu

mubelekele kunyumba? YOURSELF (1) HUSBAND/PARTNER (2) MOTHER/MOTHER-IN-LAW (3) AUNTIE (4) OTHER FAMILY MEMBER (5) FRIEND (6) OTHER (SPECIFY) (7):

D32 Nicifukwa chotani chamene inu simuna belekele kucipatala? Select all that apply.

COST TOO MUCH (1) FACILITY NOT OPEN (2) TOO FAR/NO TRANSPORTATION (3) POOR QUALITY SERVICE/DON’T TRUST (4) NO FEMALE HEALTH PROVIDER (5) HUSBAND/FAMILY DIDN’T ALLOW (6) SHORT LABOR (7) BABY CLOTHES (8) CDK (9) NO MOTHERS SHELTER (10) NOT NECESSARY (11) NOT CUSTOMARY (12) OTHER (SPECIFY) (13):

D33 Kodi inu munapita kuti chipatala kukayesedwa thanzi lanu ndi thanzi la mwana wanu pasanathe maola 24 atabeleka?


If 0 or 96, skip to Module E

MODULE E: SPENDING AND SAVINGS INTERVIEWER: "Tsopano ine ndati ndikufunseni inu za ndalama za mimba yanu yomaliza ndi za kubeleka. Taganizirani za ndalama kugwirizana ndi mimba yanu ndi za kubeleka ndi mmene munakonzekela ndalama zimenezo. "

E1 OFUNSA MAFUNSO: "Tsopano tikufuna kulankhula nkani za ndalama zina gwilisidwa nchito pakubeleka wotsiriza. Ganizilani

zinthu zimene munagula pokonzekera nkhani yanu, ulendo wanu kuchipatala kapena kunyumba kumene inu anapulumutsidwa, ndipo pa nthawi yakubeleka anu kucipatala kapena kunyumba kumene inu anabelekela. Mwakonzeka kuyamba? " Kodi ni ndalama zingati zimene munasebenzesa pa:

AMOUNT (KWACHA)

NONE (0) DON’T KNOW (96)

POKONZEKELA:

A ZOFUNIKILA (kuphatikizapo zida zofunika kuti mubeleke moyenera, magolovesi,

SURVEY ID

25

syringes, mapepala apulasitiki, tocingiliza matenda, etc.)

B ZOVALA ZA MWANA KAPENA MA BULANGETI

Pa ulendo wanu:

C MAYENDEDWE (ngati ninyumba yanu, lembani 0)

D CIPANDA ODI KAPENA MALO ENA POYEMBEKEZA KUBELEKA

Pa nthawi yobeleka:

E

MALIPILO YA OGWIRA NCHITO KAPENA YACIPATALA

F MALIPIRO YACIBWENZI

G KANGACEPE

H

MALIPILO ENA OSATI NDALAMA (pimani tandiso mu kwacha)

I MANKHWALA

J OYESA MATENDA

K ZOLIPIRA ZINA

NO. QUESTION POTENTIAL RESPONSES SKIP E2 Kodi munasungapo ndalama

zogwiritsa nchito nthawi yokacila? YES (1) NO (0) DON’T KNOW (96)

If (0) or (96), skip to E8

E3 Kodu muganizira kuti munasunga ndalama zokwanila pa ubeleki wanu othela (pacikonzekelo ca ulendo wakupita kukacila)?


E4 Kodi muna sungila kuti ndalamazi? AT YOUR HOME (1) AT A FRIEND OR FAMILY MEMBER’S HOME (2) IN A BANK ACCOUNT (3) OTHER (SPECIFY) (4):

E5 Kodi kuliko wina aliyense (mwa cinsanzo amuna anu) amene anali kuziwa malo munasungila ndalama?


SURVEY ID

26

E6 Kodi mimba yanu inali ya ikulu bwanji pamane munayamba ku sunga ndalama zobelekela?

WEEKS MONTHS

E7 Kodi ndani wina anatandizila ndalama zobelekela (pokonzekela, pa ulendo, pa nthawi yobeleka)? (Select all that apply)

HUSBAND/PARTNER (1) YOUR CHILDREN (2) PARENT/GRANDPARENT (3) OTHER FAMILY MEMBER (4) FRIEND (5) AUNTIE (6) NO ONE (7) OTHER (SPECIFY) (8):

E8 Mumaganizo anu, n'chifukwa chiyani tiyenera kusunga ndalama zobelekela?

NOT IMPORTANT (1) SLIGHTLY IMPORTANT (2) MODERATELY IMPORTANT (3) IMPORTANT (4) VERY IMPORTANT (5)

E9 Kodi munasungisapo ndalama ku banki?


E10 Kodi munatumizapo kapena kutumiziwa ndalama pa lamia ("ndalama zapa lamia")?


In (0) or (96), skip to module F

E11 Kodi muna tumila ndani “mobile money”?

HUSBAND/PARTNER (1) YOUR CHILDREN (2) PARENT/GRANDPARENT (3) OTHER FAMILY MEMBER (4) FRIEND (5) AUNTIE (6) OTHER (SPECIFY) (7):

MODULE F. POST-NATAL CARE INTERVIEWER: "Tsopano ine ndikufuna kuti ndikufunseni inu mafunso angapo za chisamaliro za umoyo wanu ndi mwana wanu analandira pambuyo paubeleki wanu wotsiriza."

NO. QUESTION POTENTIAL RESPONSES SKIP F1 Kodi inu munapita kucipatala CILI

CONSE ca postnatal pambuyo pa maola khumi ndi zinayi pambuyo pakubeleka komaliza?


If (0) or (96) skip to F6

F2 Kodi inu munapita kucipatala ca postnatal pambuyo pama siku


SURVEY ID

27

yatatu yapambuyo pakubeleka komaliza?

F3 Kodi inu munapita kucipatala cili conse ca postnatal pakati pama siku asanu ndi awiri (7) ndi khumi ndizinayi (14) pambuyo pakubeleka komaliza?


F4 Kodi inu munapita ku kucipatala CILI CONSE cha postnatal masabata asanu ndi imodzi (6) mutabeleka komaliza?


F5 INTERVIEWER: “Lomba nizakufunsani mavuto yoziwika yomwe azimai apitamo kuja kucipatala

pokalandila thandizo lopelekewa ku mzimai ndi pambuyo pobeleka. Pali zomwe ndiza culazi inu munene ngati munazipeza kukhala zokuvutani pomwe munapita kukaonewa pambuyo pobeleka mwana nthawi yathayi ndiponso munene ngati inali vuto lalikulu kapena ayi.”

MAJOR PROBLEM (2)

MINOR PROBLEM (1)

NO PROBLEM (0)

UNDECIDED (96)

A NTHAWI YOMWE MUNA YEMBEKEZELA KUTI MUONANE NDI ACIPATALA □ □ □ □

B

MPATA WOKAMBA PA ZAMAVUTO KAPENA ZODESA NKHAWA ZOKHUZA

PAKATI □ □ □ □

C

YANKHO YOMWE MUNAPATSIDWA KAPENA ZOMWE ANAKUCITILANI PAZA

VUTOLIJA □ □ □ □

D KUPIMIWA MU MALO OBISIKA KOMWE ENA SIANGAONEKO □ □ □ □

E

KUKAMBITSANA MWA CISINSI KULUBE ENA ALIWONSE OMVELAKO

ZOKAMBIDWAZO □ □ □ □

F UKHONDO WAKE WAPACIPATALAPO □ □ □ □ G ZOMWE ANCHITO ZACIPATALA

ANAKUCITILANI □ □ □ □

H MTENGO WA THANDIZO KAPENA MKHWALA OMWE MUNAPASIDWA □ □ □ □

F6 Kodi pali zomwe mugwilitsa ncito,

kapena zomwe muyesa zocedwetsa kuima kapena inu kusatenga pathupi?

YES, MODERN METHOD (1) YES, TRADITIONAL METHOD (2) NO (0) N/A, CURRENTLY PREGNANT (3) DON’T KNOW (96)

F7 INSTRUCTIONS: Look back to question B27 – Kodi mwana wobeleka komaliza ali moyo? Pempani yankho ku oyankha.



SURVEY ID

28

F8 Kodi mukali kumuyamwisa mabele mwana kuchokela pamene anabadwa?



F9 Kodi akudya zakudaya zina mwana mosakaniza ndi mkaka wamawele ndi mankhwala?


F10 Mu masabata yabili yomaliza, kodi munafuna kusamalira za umoyo za mwana wanu cifukwa ca ciliconse?


If (0) or (96), skip to F12

F11 Kodi inu poyamba muna peleka kuti mwana wanu kufufuza zau moyo?

HEALTH CARE CENTER (1) HOSPITAL (2) PHARMACY (3) TRADITIONAL HEALER (4) OTHER (SPECIFY) (5):

F12 Kodi mwana wanu analandilapo katemela uliwonse?



F13 INSTRUCTIONS: Based on D1,

calculate child’s age. Specify unit of response.

INSTRUCTIONS: Ask to see the child’s vaccination card. If available, use card to confirm the vaccines received and mark below. If card is unavailable, ask mother which vaccines the child has received. BASED ON CALCULATED AGE FROM F13, ask only about AGE APPROPRIATE vaccines.

F14 Confirm you have the child’s vaccine card in-hand.

YES (1) NO (0)

CONFIRMED BY VACCINE CARD CONFIRMED BY MOTHER RECEIVED NOT RECEIVED RECEIVED NOT RECEIVED

Kodi mwana wanu analandila katemera wotsatira pakubadwa?

A BCG □ □ □ □ B Polio (OPV-0) □ □ □ □ Kodi mwana wanu analandila katemera wotsatira wapa sabata asanu ndi imodzi?

C Polio (OPV-1) □ □ □ □ D DTP-HepB-Hib-1 □ □ □ □ E Pneumococcal (PCV) □ □ □ □ F Rotavirus □ □ □ □ Kodi mwana wanu analandila katemera wotsatira wapa sabata kumi?

G Polio (OPV-2) □ □ □ □ H DTP-HepB-Hib-2 □ □ □ □ I Pneumococcal (PCV) □ □ □ □ J Rotavirus □ □ □ □

SURVEY ID

29

Kodi mwana wanu analandila katemera wotsatira wapa sabata kumi ndi anayi?

K Polio (OPV-3) □ □ □ □ L DTP-HepB-Hib-3 □ □ □ □ M Pneumococcal (PCV) □ □ □ □

Interviewer: “Pamafunso yotsatilawa, conde muyankhe ngati mukumva bwino kuyankha. Mungasankhe kuyankha kapenanso ai.” F15 Kodi anakupimani paza tilombo

twa HIV pamimba yathai? YES (1) NO (0) PREFER NOT TO ANSWER (2) DON’T KNOW (96)

F16 Munene ngati muli ndi tilombo twa HIV kapena ayi?

INFECTED (1) NOT-INFECTED (2) PREFER NOT TO ANSWER (3) DON’T KNOW (96)

If (2), (3), or (96), skip to F23

F17 Kodi munamwa mankhwala ya ARVs pamimba yatha?


F18 INSTRUCTIONS: Refer back to question B27-28. Did the respondent’s baby survive beyond the day of birth? Confirm with respondent.


If (0) or (96), skip to Module G

F19 Kodi mwana wanu anamwa mankwala yama ARVs osachepera masabata 6 pambuyo yobadwa?

YES (1) YES, BUT BABY DIED BEFORE 6 WEEKS OF AGE (2) NO (0) DON’T KNOW (96)

F20 Kodi mwana wanu anapimiwapo za matenda ya HIV?



F21 Anakwanisa ma sabata yangati pamene mwana anapimiwa pa tulombo twa HIV? Round to nearest full number.

F22 Kodi atapimiwa utu tulombo tuna pezeka kapena ayi?

INFECTED (1) NOT INFECTED (2) PREFER NOT TO ANSWER (3) DON’T KNOW (96)

F23 Mumasiku atatu apitawa, kodi inu kapena wina aliyense munyumba mwanumu munamuchitilako

zochulidwazi mwana wanu? Select all that apply


A KUMUWELENGELA NTHANO MU MABUKU KAPENA KUMUWONETSA ZIKOPE/PIKICA □ □ □

SURVEY ID

30

B KUMUUZA TU NTHANO □ □ □

C KUYIMBA NYIMBO KAPENA TUNYIMBO

TOYIMBA MWAPANSI KUPANGA MWANA KUGONA

□ □ □

D KUMUPELEKA MWANA PANJA PANYUMBA,

KOMBONI, YADI, KAPENA MMALO OCINGILIZIWA

□ □ □ E MAINA, KUPENDA, KAPENA KUDROWINGA

VINTHU NDI MWANA □ □ □

F24 INTERVIEWER: “For the following questions, please respond only if you feel comfortable doing so. Your response is optional. I am going to read you a list of problems. Please tell me how often each of these problems has happened to you in the PAST TWO WEEKS: never, once in a while, more than half the time, or almost always.”

NEVER (0) ONCE IN A WHILE (1)

MORE THAN HALF THE TIME (2)

ALMOST ALWAYS (3)

A

MUMILUNGU IWIRI YAPITAYI, NDINALI OKALIPA KAPENA

OSAKONDWELA □ □ □ □

B

MUMILUNGUIWIRI YAPITAYI, SINDINAKHALE NDICHOFUNA

MUZOCHITIKA, KUGWIRA NCHITO, NGAKHALE KU ANTHU

□ □ □ □

C MUMILUNGU IWIRI YAPITAYI, NDINALIRA □ □ □ □

D

MUMILUNGU IWIRI YAPITAYI, NDIMALI MAUWEKHA KOMANSO

OTAYIKA □ □ □ □

F25 INTERVIEWER: “Now I am going to read you a list of things that you may have experienced. Please tell me how often each of these events have happened to you in the past two weeks: never, once in a while, a few times, or many times. Again, please respond only if you feel comfortable doing so. Your response is optional.”

NEVER (0) ONCE (1) A FEW TIMES (2) MANY TIMES (3) N/A (4)

A

MUMILUNGU IWIRI YAPITAYI, NDIKANGATI KAMENE AMUNA

KAPENA OKONDEDWA ANU ANAKUKANKHANI KAPENA

KUKUPANDANI KUTSAYA

□ □ □ □ □

B

MUMILUNGU IWIRI YAPITAYI, NDIKANGATI KAMENE AMUNA

ANU KAPENA OKONDEDWA ADAKUKOKOTANI, KUKUPANDANI,

KUKUGWIRANI PAKHOSI KAPENA KUKUTENTHANI??

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SURVEY ID

31

MODULE G. LAST PREGNANCY INTERVIEWER: "Tsopano ine ndati ndikufunseni inu mafunso ena amene ali enieni pa mimba yanu kufika kwa kubeleka posachedwa. Ganizilani zimene zinachitika pamene inu munadziwa kuti mulina mimba ndi zokhudza chithandizo chaku antenatal. Mwakonzeka kuyamba? "

NO. QUESTION POTENTIAL RESPONSES SKIP Interviewer: Ask to see if antenatal care card is available for the woman’s last pregnancy that led to a delivery and confirm information provided by respondent. G1 Did the woman provide you with

her antenatal card? YES (1) NO (0) DON’T KNOW (96)

G2 Kodi nikangati komwe inu munalandila thandizo la antenatal pamene munali ndi pakati?

NONE (0) ONE TIME (1) TWO TIMES (2) THREE TIMES (3) FOUR TIMES (4) MORE THAN FOUR TIMES (5)

If (0) skip to End of Survey

G3 Pamene munali kukatemela, munakambisanako pa izi:


A Mungacilile kuti ikakwana nthawi? □ □ □

B Munga citenji ngati mwa peza vuto ndi mimba? □ □ □

C Kusunga ndalama zolipira mimba ikauka ndi paku

beleka? □ □ □

D Kodi muganizila kubeleka siku liti? □ □ □

G4 Kodi mukumbukira zimene munauzidwa za siku yobeleka?


If (0), skip to G6

G5 Munali kuyembekezela kubeleka liti? (DD MONTH YYYY) If EDD is on ANC card, copy it from card. If no card and date not know, enter 15th

____ ____ ____ ____ ____ ____ ____ ____ D D M M Y Y Y Y

G6 Paulendo wanu WOYAMBA waku ANC, munali ndi pakati pa ma sabata kapena myezi ingati? Chonde, sankani mopendela yankho.

WEEKS MONTHS

SURVEY ID

32

INTERVIEWER: "Ife tafika ku mapeto a kafukufukuyu. Tikukuthokozani chifukwa chopatula nthawi kuyankha mafunso awa. Kodi muli ndi ndemanga zoonjezera mungakonde kuwonjezera? "

G7 Would you be willing to have someone come back and follow up on a few questions from the survey in the next couple of days?

YES (1) NO (0)

COMMENTS:

END OF SURVEY

INSTRUMENT REVIEW

Enumerator Initials:

Data Entry Initials:

Date (DD/MM/YYYY)

Date (DD/MM/YYYY)

Supervisor Initials:

Supervisor Initials:

Date (DD/MM/YYYY)

Date (DD/MM/YYYY)

household survey nyanja short screen - plos

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